Before the chair got wheels, the infirm rich were carried in sedan chairs. In the 1500s, Philip II of Spain used a wheeled chair because of gout. In the 1700s, Viscountess Tyrconnel sat on a scooter-like chair for a family portrait. By the late 1700s, rich invalids hired a chair in order to enjoy a spa’s social season. Most impairments were from general debility. Prior to the mid-20th century, paralysis patients usually died within a few months.